1. Field of the Invention
This invention relates to a surgical device for holding an opening in a blood vessel in open position and to a method of using this device for holding an opening in a first blood vessel in position for anastomosis to an opening in a second blood vessel during a surgical procedure.
The blood vessel holder of this invention is especially suited for maintaining an opening in a first blood vessel in position for suturing to an opening in another blood vessel, for example in anastomosing an open-ended vein to a side opening in the aorta or one of its branches. Side-to-side and end-to-end anastomoses may also be performed with this blood vessel holder. This blood vessel holder is also suited for use in joining sections of other tubular bodily structures, e.g. bowel, fallopian tubes, etc. The present blood vessel holder is particularly suited for use during coronary bypass and peripheral vascular surgery. The blood vessels or other tubular bodily structures may be of biological or synthetic origin.
2. Description of the Prior Art
In procedures where the opening blood vessel is to be joined to the opening in a second blood vessel, such holding devices as forceps have commonly been used to maintain the first blood vessel in position while sutures to the second blood vessel are placed. It is easy for the blood vessel or forceps to slip, and the wall of the blood vessel is susceptible to traumatic damage. In attempting to overcome the problems inherent to the use of forceps in such procedures, a number of blood vessel holding devices have been proposed.
The Huang vein holder, available from Codman and Shurtleff, Incorporated, Randolph, Mass., presents a slender hollow tubular handle with an open tapering tip at one end for insertion into the open end of a blood vessel to maintain it in position for anastomosis. To secure the blood vessel to the Huang vein holder, an eye hook is provided on the exterior of the tubular handle at the base of the open tapering tip. The Huang vein holder is cumbersome to use, as it requires a suture to be placed each time the blood vessel is applied to the holder. This unduly lengthens the surgical procedure, because of the time and care required for placement and removal of such sutures.
Suma, et al describe a vein holder for coronary bypass surgery in Ann. Thorac. Surg. 43:109-110, January 1987. Their vein holder for distal (vein graft-to-coronary artery) anastomosis is constructed with an outer sheath and inner shaft. The outer sheath is constructed for insertion into the lumen of a vein graft. The inner sheath has three linear pins at the end of the shaft that expand when the outer sheath is slid back, so as to hold the incision open by expanding the vein. Their vein holder for proximal (vein graft-to-aorta) anastomosis has a bullet-shaped hollow body and perpendicular flat arm. Neither of these vein holders provide any Positive feature for contact with the exterior of the vein to securely hold the vein in position, and thus slippage and collapse of the vein is possible during the anastomosis procedure.
U.S. Pat. No. 4,651,731, issued Mar. 24, 1987 to Mobin-Uddin describes a surgical blood vessel holding device having a shank means in a middle region with a handle at one end and a narrow prong at the other end. The prong is provided with a hook extending laterally from the side thereof. The prong is adapted to be inserted into the open end of a blood vessel until the hook reaches the distal end of the vessel. The hook then pierces the vessel wall allowing the device to dispose the end of the blood vessel in facing relationship with respect to an opening in the wall of another blood vessel. The blood vessel can be locked onto the hook. A few sutures are then taken to hold the two blood vessels in facing relationship. The prong is then unhooked, removed, and suturing is completed. This device is susceptible to mispositioning during use. The vein, once hooked into position can easily slip off the hook if tension is slightly reduced. The amount of tension to be applied requires extreme practice and coordination. The longitudinally slidable locking clip which may be provided to reduce the possibility of slippage pinches the vein and may cause undue trauma thereto. This device is thus extremely tedious and difficult to use.
The design and function of the blood vessel holding device of this invention is intended to obviate the various problems associated with the use of these previously available blood vessel holders.